Advertisement

Relative long-term survival in out-of-hospital cardiac arrest: Is it really improving?

  • David Majewski
    Correspondence
    Corresponding author at: Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery, and Paramedicine, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery, and Paramedicine, Curtin University, Bentley, WA, Australia
    Search for articles by this author
  • Stephen Ball
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery, and Paramedicine, Curtin University, Bentley, WA, Australia

    St John WA, Belmont, WA, Australia
    Search for articles by this author
  • Paul Bailey
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery, and Paramedicine, Curtin University, Bentley, WA, Australia

    St John WA, Belmont, WA, Australia
    Search for articles by this author
  • Janet Bray
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery, and Paramedicine, Curtin University, Bentley, WA, Australia

    School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
    Search for articles by this author
  • Judith Finn
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery, and Paramedicine, Curtin University, Bentley, WA, Australia

    Medical School (Emergency Medicine), The University of Western Australia, Crawley, WA, Australia

    St John WA, Belmont, WA, Australia

    School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
    Search for articles by this author

      Abstract

      Aim

      To describe the long-term survival of out-of-hospital cardiac arrest (OHCA) patients and to determine whether survival is improving in comparison to the general age- and sex-matched population.

      Methods

      We utilised the St John Western Australia (WA) OHCA database to retrospectively identify patients aged ≥16 years who experienced an OHCA within the Perth metropolitan area between 1998 and 2017 and survived for at least 30-days post arrest. Patients were excluded if their primary residence was not WA, they did not have an emergency medical services attempted resuscitation (or bystander defibrillation) or did not have an arrest of medical aetiology. Relative survival ratios stratified by decade of arrest were calculated by dividing observed survival of the study cohort by the expected survival of an age- and sex-matched cohort estimated from the Australian Bureau of Statistics life tables for WA.

      Results

      The OHCA patients who initially survived to 30-days experienced a modest reduction in long-term survival, with 84% (95% CI, 78–90) of patients surviving to 10-years relative to the age- and sex-matched general population. The 10-year relative survival increased from 76% (95% CI, 67–85) to 92% (95% CI, 84–100) between the first (1998−2007) and second (2008−2017) decade of our study.

      Conclusion

      Relative long-term survival prospects for initial OHCA survivors are moderately lower than that of the general population, however these differences have reduced over time and may be approaching those of the general population.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Resuscitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Yan S.
        • Gan Y.
        • Jiang N.
        • et al.
        The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis.
        Crit Care (London, Engl). 2020; 24: 61
        • Perme M.P.
        • Pavlic K.
        Nonparametric relative survival analysis with the R package relsurv.
        J Stat Software. 2018; 2018;87: 27
        • Perkins G.D.
        • Jacobs I.G.
        • Nadkarni V.M.
        • et al.
        Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein Resuscitation Registry Templates for Out-of-Hospital Cardiac Arrest: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation.
        Circulation. 2015; 132: 1286-1300
        • Australian Bureau of Statistics
        3101.0 – Australian Demographic Statistics, Dec 2019.
        2020 (Accessed 21 July 2020 at: https://www.abs.gov.au/AUSSTATS/[email protected]/mf/3218.0)
        • Lambert P.C.
        • Dickman P.W.
        • Rutherford M.J.
        Comparison of different approaches to estimating age standardized net survival.
        BMC Med Res Methodol. 2015; 15: 64
        • Ederer F.
        • Heise H.
        Instructions to IBM 650 programmers in processing survival computations. Methodological note no. 10. End results evaluation section.
        National Cancer Institute: Bethseda, 1959
        • Coleman M.P.
        • Quaresma M.
        • Berrino F.
        • et al.
        Cancer survival in five continents: a worldwide population-based study (CONCORD).
        Lancet Oncol. 2008; 9: 730-756
        • Dickman Pw
        • Adami Ho.
        Interpreting trends in cancer patient survival.
        J Intern Med. 2006; 260: 103-117
        • Wong M.K.
        • Morrison L.J.
        • Qiu F.
        • et al.
        Trends in short- and long-term survival among out-of-hospital cardiac arrest patients alive at hospital arrival.
        Circulation. 2014; 130: 1883-1890
        • Larribau R.
        • Deham H.
        • Niquille M.
        • Sarasin F.P.
        Improvement of out-of-hospital cardiac arrest survival rate after implementation of the 2010 resuscitation guidelines.
        PLoS One. 2018; 13: e0204169
        • Bray J.E.
        • Di Palma S.
        • Jacobs I.
        • Straney L.
        • Finn J.
        Trends in the incidence of presumed cardiac out-of-hospital cardiac arrest in Perth, Western Australia, 1997–2010.
        Resuscitation. 2014; 85: 757-761
        • Bunch T.J.
        • White R.D.
        • Gersh B.J.
        • et al.
        Long-Term Outcomes of Out-of-Hospital Cardiac Arrest after Successful Early Defibrillation.
        N Engl J Med. 2003; 348: 2626-2633
        • Majewski D.
        • Ball S.
        • Finn J.
        Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes.
        BMJ Open. 2019; 9e031655
        • Andrew E.
        • Nehme Z.
        • Wolfe R.
        • Bernard S.
        • Smith K.
        Long-term survival following out-of-hospital cardiac arrest.
        Heart. 2017; 103: 1104-1110